Fixture for spatial positioning of a device

ABSTRACT

In a fixture ( 1 ) for spatial positioning of a device ( 2 ), in particular a device for medical application, that is supported in a pivoting arrangement on a holding device ( 5 ) or the like by means of an arm ( 6 ), quick and easy alignment of the device ( 2 ) in relation to a person&#39;s treatment area should be guaranteed. This is achieved in that a ring-shaped holding body ( 11 ) is attached to the free end of the arm ( 6 ), that a spherical cup-shaped outer jacket surface ( 13 ) is provided on the device ( 2 ) with the surface enclosed wholly or in part by the holding body ( 11 ) and that the outer jacket surface ( 13 ) of the device ( 2 ) is held in the holding body ( 11 ) and can be pivoted relative to the holding body ( 11 ).

The present invention relates to a fixture for spatial positioning of a device, specifically a device with a medical application, that is supported in a pivoting arrangement on a holding device or the like by means of an arm.

A localisation and positioning fixture of this kind is disclosed in DE 3427 001 C1, which can principally be moved in space along a rail bent into a C-shape. The patient's treatment area is preferably positioned in the centre of the C-shaped rail. A fixture of this kind can be used for supporting both X-ray and shock wave generation devices for treating bone growth or for lithotripsy of kidney stones. Accordingly, the medical device is aligned along an arc located on the same plane as the patient's treatment area.

A disadvantage of the state-of-the-art has proven to be that the treatment area must be positioned centrally in relation to the arc-shaped arrangement of the holding fixture in order for the X-ray beams or the focal point of the generated shock waves to be oriented specifically for the device. This means even minor positioning inaccuracies outside the centre point of the holding fixture can lead to unwanted medical side effects. For example, the shock waves have a characteristic that is not suitable for the required successful treatment effect in this position. Therefore, it is necessary to ensure at all times that the patient's treatment area is in precisely the spatial area of the centre of the arc-shaped holding fixture.

A further disadvantage is that the device can exclusively be aligned in one plane in relation to the treatment area. As a result, geometrical adaptations intended to arrange the treatment area in the specified centre point are very time consuming because the treatment area, i.e. the patient, must be precisely positioned with regard to the holding fixture and must be fixed in this position for the duration of the treatment. This is because the device in accordance with the state-of-the-art can only be used along the holding fixture in accordance with the rail bent into a C-shape, meaning that the alignment of the device is two-dimensional.

The task of the present invention is therefore to provide a fixture of the type specified above by means of which the device can be aligned and secured in the space in relation to a patient's treatment area. The movement of the device should be easy and efficient.

This task is accomplished in that a ring-shaped holding body is attached to the free end of the arm, that a spherical cup-shaped outer jacket surface is provided on the device and the surface is enclosed in whole or in part by the holding body and that the outer jacket surface of the device is held in the holding body and can be swivelled relative to the holding body.

Further advantageous embodiments of the invention are disclosed in the subordinate claims.

It is particularly advantageous for the inside of the holding body to be arranged at a distance from the outer jacket surface if the inside runs concentrically to the outer jacket surface and if at least one plain or anti-friction bearing is provided between the holding body and supported against it, with the bearing acting against the outer jacket surface, because the plain or anti-friction bearing permits a relative movement between the device and the holding body as a component of the holding fixture and this relative movement can be performed in two of the three spatial vectors.

The movement between the outer jacket surface and the holding body is guaranteed by the geometrical arrangement of the outer jacket surface and the inner contour of the holding body that is adapted to the outer jacket surface, without the device slipping out of the holding body as a result of the positioning possibilities. Instead, the ring-shaped holding body partially or entirely encloses the outer jacket surface in order to support it and, at the same time, to provide a relative movement in space.

The alignment and positioning options of the device in the space are increased because the holding device consists of an arm with a swivel joint provided at its end between the end of the arm and the holding body, with the effect that the device can be swivelled about the lengthways axis of the arm. As a result, two subsections overlap for the adjustment possibility of the device in a vertical plane. Both subsections of the adjusting angle overlap within a spatially limited area in order to achieve an overall adjusting angle range of +/−45°. Furthermore, the device can be moved within an adjusting angle of +/−26° in an adjusting plane running perpendicular to the lengthways axis of the device and parallel to the lengthways axis of the arm so that the overlapping of the two adjusting movements allows the device to be aligned diagonally in space overall.

The adjusting angle is limited by the geometrical dimensions of the outer jacket surface with regard to the diameter of the cylindrically shaped device. The cylindrical jacket surface of the device arranged immediately adjacent to the outer jacket surface namely acts as a stop and is in contact with the side area of the holding body at the maximum possible set deflection.

The drawing shows a sample embodiments in accordance with the present invention, the details of which are explained below. In the drawing,

FIG. 1 shows a fixture for spatial positioning of a shock wave generator device that is supported by an arm on a holding device, in a perspective view,

FIG. 2 shows the fixture in accordance with FIG. 1, along the section line II-II,

FIG. 3 shows the fixture in accordance with FIG. 2, along the section line III-III,

FIG. 4 shows a magnified partial view of the fixture from FIG. 2 in the area IV.

FIG. 1 shows a fixture 1 for holding a medical device 2 by means of which, for example, shock waves can be generated for lithotripsy of kidney stones or for treating bone growth or for healing wounds. The shock waves generated by the device 2 should pass through a diaphragm bellows 3 directly into a treatment area 4 indicated schematically and located inside a patient (not illustrated). The diaphragm bellows 3 contacts the patient's skin or is arranged at a distance from the patient. The medical device 2 can also be configured as an X-ray device or the like and be arranged at a distance from the treatment area 4 or the patient.

The device 2 is attached to a holding device 5 configured as a carriage by means of an L-shaped arm 6. The holding device 5 can consequently be moved along a base. The L-shaped arm 6 consists of a swivel joint 7 arranged between the sections of the arm 6 with the effect that the arm 6 can be pivoted through 360° in relation to the holding device 5. Furthermore, the swivel joint 7 can be moved along the vertical section of the arm 6 in order to adjust the height.

A swivel joint 21 is provided at the free end of the arm 6 and is explained in more detail below. A holding body 11 is attached to the swivel joint 21 and the entirety of the holding body 11 forms a completely enclosed ring. The holding body 11 is configured in two parts for installation and removal purposes. Furthermore, the holding body 11 can be configured as an open ring, however one with a ring section of at least 185°.

The device 2 principally consists of a housing with a cylinder-shaped jacket surface 27. A spherical cup-shaped outer jacket surface 13 is provided approximately in the geometrical centre of the device 2 and is completely or partly enclosed by the holding body 11. Consequently, the device 2 is supported on the holding device 5 by the holding body 11 in such a way that the device 2 can be moved relative to the holding body 11.

FIGS. 2 and 4 show that the holding body 11 has a concentrically curved inside 12 that runs at a distance from the outer jacket surface 13. There should be a constant distance between these two surfaces in order to accommodate a plain or anti-friction bearing by means of which the device 2 is supported in a pivoting arrangement on the holding body 11.

Two rings 14 and 15 are inserted on the inside 12 of the holding body and a plurality of balls 16 is inserted in these rings in a rotating arrangement. The rings 14 and 15 therefore combine with the balls 16 to form two anti-friction bearings located at a distance from one another by means of which the outer jacket surface 13 is held in a pivoting arrangement without the possibility of the housing 2 being pulled out from the holding body 11 in the direction of its lengthways axis 9. By means of a similar design, one or two plain bearings can be accommodated in the inside of the holding body 11. The lengthways axis 9 in this case corresponds to the Z-axis of the system of coordinates shown in FIG. 1; the possibility of moving the device 2 or the diaphragm bellows 3 is defined by the plane formed by the X-axis and the Y-axis.

The distance between the inside 12 and the outer jacket surface 13 corresponds to the spherical radius of the balls 16. Furthermore, the balls 16 make perpendicular contact with the outer jacket surface 13 irrespective of the angle position of the outer jacket surface 13 in relation to the holding body 11.

Furthermore, a brake 17 is allocated to the inside 12 of the holding body 11, and the brake 17 is held in a fixed location in the holding body 11 and runs approximately centrally between the two rings 14 and 15. The brake 17 acts on the outer jacket surface 13 in such a way that the movement of the device 2 is stopped by the brake bodies 17′ inserted in the brake 17. For this purpose, the brake 17 is composed of two holding rings, the free opposite ends of which are held together by an actuator 18.

FIG. 3 shows the means of function of the actuator 18 that is connected to the two free ends of the brake 17 by means of an angle lever. Moving the actuator 18 towards the device 2 therefore presses apart the two free ends due to the effect of the angle lever, and consequently the internal diameter of the brake 17 increases so that the friction force acting on the outer jacket surface 13 is reduced or entirely cancelled. The brake bodies 17′ are consequently arranged at a distance from the outer jacket surface 13. This means the device 2 can be moved relative to the holding body 11. Movement of the actuator 18 additionally presses a return spring 19 together. If the actuator 18 is then released, the return spring 19 presses the two free ends of the brake 17 together with the effect that braking force once again acts on the outer jacket surface 13 by means of the brake bodies 17′ and therefore movement of the device 2 relative to the holding body 11 is not possible, or only possible by exerting considerable force.

Furthermore, FIG. 3 shows that the holding body 11 is connected by means of the swivel joint 21 that is configured in the form of a dovetail guide 22. One section of the arm 6 is composed of two struts 8 that can be pushed one inside the other in a telescopic arrangement. For installation purposes, the struts 8 can be disconnected from one another with the effect that the inside of the subsection assigned to the holding body 11 can be accessed from the outside. A cover 23 is provided for covering the dovetail guide 22, with the cover 23 being locked in place by a screw 24 arranged inside the strut 8. This means the holding body 11 can be moved perpendicular about the lengthways axis of the strut 8 due to the presence of the swivel joint 21.

FIG. 1 in particular shows the directions in which the device 2 can be aligned in space. Two handles 25 are provided on opposite sides of the device 2 for this purpose.

The device 2 can be moved in a vertical direction about the swivel joint 21, i.e. about the lengthways axis of the struts 8. Furthermore, the device 2 can be aligned in a plane running parallel to the lengthways axis of the struts 8 because the outer jacket surface 13 can be moved within the holding body 11 until the cylinder jacket surface 27 that runs in the area of the outer jacket surface 13 makes contact with the end of the holding body 11 as a stop 28.

In the selected sample embodiment, the geometrical relationships between the diameter of the outer jacket surface 13 and the internal diameter of the holding body 11 have been selected in such a way that an adjustment angle a of +/−26° about the centre 20 of the device 2 is possible. This is a first subsection of the adjustment angle a. A second subsection of the adjustment angle a is generated by means of the opportunities to rotate the swivel joint 21. The deflection in a vertical direction, i.e. in the plane running at right angles to the lengthways axis 9 of the device 2, is approx. +/−45°.

Due to the design of the fixture 1, it is now possible for the patient and/or his or her treatment area 4 to remain fixed and stationary. The device 2 can be positioned precisely in relation to the treatment area 4 without the need for the area to be moved. A monitor 26 with a localisation and navigation system (not illustrated) is provided for this purpose, by means of which the doctor conducting the treatment is able permanently to monitor the alignment of the device 2 in relation to the treatment area 4. 

1. A fixture (1) for spatial positioning of a device (2), specifically a device with a medical application, that is supported in a pivoting arrangement on a holding device (5) or the like by means of an arm (6), characterised in that, a ring-shaped holding body (11) is attached to the free end of the arm (6), that a spherical cup-shaped outer jacket surface (13) is provided on the device (2) and the surface is enclosed in whole or in part by the holding body (11) and that the outer jacket surface (13) of the device (2) is held in the holding body (11) and can be swivelled relative to the holding body.
 2. The fixture in accordance with claim 1, characterised in that, the inside (12) of the holding body (11) is arranged at a distance from the outer jacket surface (13), that the inside (12) runs concentrically to the outer jacket surface (13) and that at least one plain or anti-friction bearing (13, 15, 16) is provided between the holding body (11) and supported against it, with the bearing acting against the outer jacket surface (13).
 3. The fixture in accordance with claim 2, characterised in that, the anti-friction bearing consists of two rings (14, 15) that are permanently attached inside the holding body (11) and aligned with spaces in between them, that the two rings (14, 15) run parallel to one another and perpendicular to the lengthways axis of the device (2), that a plurality of roller bodies are inserted in both rings (14, 15), project from the rings, are preferably shaped as balls (16) and are in contact with the outer jacket surface (13) of the device (2), and that the roller bodies (16) are mounted in a rotating arrangement in the ring (14, 15) in question.
 4. The fixture in accordance claim 3, characterised in that, both rings (14, 15) are arranged in the area of both ends of the holding body (11) and that the curvature of the rings (14, 15) runs concentrically to the outer jacket surface (13).
 5. The fixture in accordance with claim 4, characterised in that, each of the roller bodies (16) contacts the outer jacket surface (13) of the device (2) vertically.
 6. The fixture in accordance with one or more of the aforementioned claims, characterised in that, a swivel joint (21) is arranged between the holding body (11) and the arm (6) by means of which the device (2) can be movably aligned perpendicular to the axis (10) formed by the arm (6).
 7. The fixture in accordance with claim 6, characterised in that, the swivel joint (21) consists of two guide elements (22, 23) rotatably arranged one inside the other, which are preferably connected together in the form of a dovetail guide (22).
 8. The fixture in accordance with claim 7, characterised in that, the openings in the dovetail guide (22) are closed by a cover (23) or the like in the direction of the lengthways axis (10) of the arm (6).
 9. The fixture in accordance with one or more of the aforementioned claims, characterised in that, an externally operated brake (17) is provided in the inside of the holding body (11) and the brake contacts the outer jacket surface (13) and has an adjustable effect on it.
 10. The fixture in accordance with claim 9, characterised in that, the brake (17) consists of a two-part ring that completely encloses the outer jacket surface (13) and the two free ends of which can be pressed apart from the outside by means of an actuator (18), and that the two free ends of the brake (17) are pressed together by a return spring (19).
 11. The fixture in accordance with claim 9 or 10, characterised in that, the brake (17) is in the central plane of the holding body (11).
 12. The fixture in accordance with one or more of the aforementioned claims, characterised in that, that the arm (6) is formed by two support struts (8) that can be telescoped one inside the other.
 13. The fixture in accordance with one or more of the aforementioned claims, characterised in that, in order to align the device (2) manually, one or more handles (25) is/are provided on the device.
 14. The fixture in accordance with one or more of the aforementioned claims, characterised in that, the surface of the device (2) that runs parallel to the lengthways axis (9) of the device and in the area of the outer jacket surface (13) serves as the stop (28) for the freedom of movement of the device (2).
 15. The fixture in accordance with one or more of the aforementioned claims, characterised in that, the outer jacket surface (13) is configured in such a way that the roller bodies (16) roll along the surface with as little friction as possible.
 16. The fixture in accordance with one or more of the aforementioned claims, characterised in that, the device (2) can be moved in a first plane that runs perpendicular to the lengthways axis (9) of the device within an adjusting angle (a) of +/−26° and in a second plane that runs perpendicular to the first plane within an adjusting angle (β) of +/−45°.
 17. The fixture in accordance with claim 16, characterised in that, the adjusting angle (β) is divided into two different adjustment sections. 